Individual
MIKE MOISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2792 DONNELLY DR, LANTANA, FL 33462-6431
(561) 702-5196
Mailing address
2792 DONNELLY DR, LANTANA, FL 33462-6431
(561) 702-5196
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA18550
FL
Other
Enumeration date
01/20/2010
Last updated
01/20/2010
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